早期CADASIL微血管功能和结构的改变。

IF 2 4区医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Magnetic resonance imaging Pub Date : 2025-05-19 DOI:10.1016/j.mri.2025.110402

Shan Tian , Hongwei Li , Junting Yang , Yuna Li , Yuan Qiao , Chaohua Cong , Lei Zhao , Panlong Li , He Wang , Jingjing Su

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引用次数: 0

摘要

背景：大脑常染色体显性动脉病变伴皮质下梗死和白质脑病（CADASIL）是遗传性脑小血管疾病（CSVD）最常见的单基因形式。虽然研究已经证明了CADASIL患者脑血管反应性（CVR）和灰质结构的异质性改变，但CVR和脑结构成像在诊断CADASIL中的应用仍然不确定。方法：本研究调查了22例CADASIL患者的CVR和灰质密度（GMD），并与21例年龄和性别匹配的健康对照组进行了比较。静息状态功能磁共振成像（fMRI）评估区域CVR变化，而基于体素的形态测量（VBM）分析GMD差异。本研究进一步探讨了CVR和GMD改变与CADASIL患者临床评分的相关性。最后，通过受试者工作特征（ROC）曲线分析，包括曲线下面积（AUC）计算，确定CVR诊断CADASIL的准确性和形态学指标。结果：与对照组相比，CADASIL患者左侧黑质CVR明显降低，双侧大脑前近动脉（ACA） CVR明显升高。VBM显示CADASIL患者双侧丘脑亚区GMD降低，与多项临床指标显著相关。与GMD （AUC = 0.654）相比，CVR指标对CADASIL的诊断准确性更高（AUC = 0.853）。结论：CVR指标在CADASIL患者中的显著变化提示CVR指标可作为CADASIL诊断的潜在生物标志物。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

Microvascular functional and structural changes in early-stage CADASIL

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Microvascular functional and structural changes in early-stage CADASIL

Background

Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is the most common monogenic form of hereditary cerebral small vessel disease (CSVD). While studies have demonstrated heterogeneous alterations in cerebrovascular reactivity (CVR) and gray matter structure in CADASIL patients, the diagnostic utility of CVR and brain structural imaging in identifying CADASIL remains uncertain.

Methods

This study investigated CVR and gray matter density (GMD) in 22 CADASIL patients compared to 21 age- and sex-matched healthy controls. Resting-state functional magnetic resonance imaging (fMRI) assessed regional CVR changes, while voxel-based morphometry (VBM) analyzed GMD differences. The study further explored the correlation between CVR and GMD alterations with clinical scores in CADASIL patients. Finally, receiver operating characteristic (ROC) curve analysis, including the area under curve (AUC) calculation, determined the diagnostic accuracy of CVR and morphological indices for CADASIL.

Results

Compared to controls, CADASIL patients exhibited significantly lower CVR in the left substantia nigra and higher CVR in the bilateral proximal anterior cerebral artery (ACA). VBM revealed reduced GMD in bilateral thalamic subregions in CADASIL patients, significantly correlating with several clinical measures. CVR indicators demonstrated superior diagnostic accuracy for CADASIL (AUC = 0.853) compared to GMD (AUC = 0.654).

Conclusion

The significant changes in CVR indices observed in CADASIL patients suggest that these indices may serve as potential biomarkers for CADASIL diagnosis.

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来源期刊

Magnetic resonance imaging 医学-核医学

CiteScore

4.70

自引率

4.00%

发文量

194

审稿时长

83 days

期刊介绍： Magnetic Resonance Imaging (MRI) is the first international multidisciplinary journal encompassing physical, life, and clinical science investigations as they relate to the development and use of magnetic resonance imaging. MRI is dedicated to both basic research, technological innovation and applications, providing a single forum for communication among radiologists, physicists, chemists, biochemists, biologists, engineers, internists, pathologists, physiologists, computer scientists, and mathematicians.